Epilepsy

With the vision of including authors from different parts of the world, different educational backgrounds, and offering open-access to their published work, InTech proudly presents the latest edited book in epilepsy research, Epilepsy: Histological, electroencephalographic, and psychological aspects. Here are twelve interesting and inspiring chapters dealing with basic molecular and cellular mechanisms underlying epileptic seizures, electroencephalographic findings, and neuropsychological, psychological, and psychiatric aspects of epileptic seizures, but non-epileptic as well

An overview of deep learning techniques for epileptic seizures detection and prediction based on neuroimaging modalities: Methods, challenges, and future works

Epilepsy is a disorder of the brain denoted by frequent seizures. The symptoms of seizure include confusion, abnormal staring, and rapid, sudden, and uncontrollable hand movements. Epileptic seizure detection methods involve neurological exams, blood tests, neuropsychological tests, and neuroimaging modalities. Among these, neuroimaging modalities have received considerable attention from specialist physicians. One method to facilitate the accurate and fast diagnosis of epileptic seizures is to employ computer-aided diagnosis systems (CADS) based on deep learning (DL) and neuroimaging modalities. This paper has studied a comprehensive overview of DL methods employed for epileptic seizures detection and prediction using neuroimaging modalities. First, DLbased CADS for epileptic seizures detection and prediction using neuroimaging modalities are discussed. Also, descriptions of various datasets, preprocessing algorithms, and DL models which have been used for epileptic seizures detection and prediction have been included. Then, research on rehabilitation tools has been presented, which contains brain-computer interface (BCI), cloud computing, internet of things (IoT), hardware implementation of DL techniques on field-programmable gate array (FPGA), etc. In the discussion section, a comparison has been carried out between research on epileptic seizure detection and prediction. The challenges in epileptic seizures detection and prediction using neuroimaging modalities and DL models have been described. In addition, possible directions for future works in this field, specifically for solving challenges in datasets, DL, rehabilitation, and hardware models, have been proposed. The final section is dedicated to the conclusion which summarizes the significant findings of the paper

Artifact Removal Methods in EEG Recordings: A Review

To obtain the correct analysis of electroencephalogram (EEG) signals, non-physiological and physiological artifacts should be removed from EEG signals. This study aims to give an overview on the existing methodology for removing physiological artifacts, e.g., ocular, cardiac, and muscle artifacts. The datasets, simulation platforms, and performance measures of artifact removal methods in previous related research are summarized. The advantages and disadvantages of each technique are discussed, including regression method, filtering method, blind source separation (BSS), wavelet transform (WT), empirical mode decomposition (EMD), singular spectrum analysis (SSA), and independent vector analysis (IVA). Also, the applications of hybrid approaches are presented, including discrete wavelet transform - adaptive filtering method (DWT-AFM), DWT-BSS, EMD-BSS, singular spectrum analysis - adaptive noise canceler (SSA-ANC), SSA-BSS, and EMD-IVA. Finally, a comparative analysis for these existing methods is provided based on their performance and merits. The result shows that hybrid methods can remove the artifacts more effectively than individual methods

UNSUPERVISED CLASSIFICATION OF HIGH-FREQUENCY OSCILLATIONS IN NEOCORTICAL EPILEPSY AND CONTROL PATIENTS

Quality of life for the more than 15 million people with drug-resistant epilepsy is tied to how precisely the brain areas responsible for generating their seizures can be localized. High-frequency (100-500 Hz) field-potential oscillations (HFOs) are emerging as a candidate biomarker for epileptogenic networks, but quantitative HFO studies are hampered by selection bias arising out of the need to reduce large volumes of data in the absence of capable automated processing methods. In this thesis, I introduce and evaluate an algorithm for the automatic detection and classification of HFOs that can be deployed without human intervention across long, continuous data records from large numbers of patients. I then use the algorithm in analyzing unique macro- and microelectrode intracranial electroencephalographic recordings from human neocortical epilepsy patients and controls. A central finding is that one class of HFOs discovered by the algorithm (median bandpassed spectral centroid ~140 Hz) is more prevalent in the seizure onset zone than outside. The outcomes of this work add to our understanding of epileptogenic networks and are suitable for near-term translation into improved surgical and device-based treatments

Neural Anomalies Monitoring: Applications to Epileptic Seizure Detection and Prediction

There have been numerous efforts in the field of electronics with the aim of merging the areas of healthcare and technology in the form of low power, more efficient hardware. However one area of development that can aid in the bridge of healthcare and emerging technology is in Information and Communication Technology (ICT). Here, databasing and analysis systems can help bridge the wealth of information available (blood tests, genetic information, neural data) into a common framework of analysis. Also, ICT systems can integrate real-time processing from emerging technological solutions, such as developed low-power electronics. This work is based on this idea, merging technological solutions in the form of ICT with the need in healthcare to identify normality in a patients’ health profile. In this work we develop this idea and explain the concept more thoroughly. We then go on to explore two applications under development. The first is a system designed around monitoring neural activity and identifying, through a processing algorithm, what is normal activity, such that we can identify anomalies, or abnormalities in the signal. We explore Epilespy with seizure detection and prediction as an application case study to show the potential of this method. The motivation being that current methods of prediction have proven to be unsuccessful. We show that using our algorithm we can achieve significant success in seizure prediction and detection, above and beyond current methods. The second application explores the link between genetic information and standard tests (blood, urine etc...) and how they link in together to define a personalised benchmark. We show how this could work and the steps that have been made towards developing such a database

Intraoperative Guidance for Pediatric Brain Surgery based on Optical Techniques

For most of the patients with brain tumors and/or epilepsy, surgical resection of brain lesions, when applicable, remains one of the optimal treatment options. The success of the surgery hinges on accurate demarcation of neoplastic and epileptogenic brain tissue. The primary goal of this PhD dissertation is to demonstrate the feasibility of using various optical techniques in conjunction with sophisticated signal processing algorithms to differentiate brain tumor and epileptogenic cortex from normal brain tissue intraoperatively. In this dissertation, a new tissue differentiation algorithm was developed to detect brain tumors in vivo using a probe-based diffuse reflectance spectroscopy system. The system as well as the algorithm were validated experimentally on 20 pediatric patients undergoing brain tumor surgery at Nicklaus Children’s Hospital. Based on the three indicative parameters, which reflect hemodynamic and structural characteristics, the new algorithm was able to differentiate brain tumors from the normal brain with a very high accuracy. The main drawbacks of the probe-based system were its high susceptibility to artifacts induced by hand motion and its interference to the surgical procedure. Therefore, a new optical measurement scheme and its companion spectral interpretation algorithm were devised. The new measurement scheme was evaluated both theoretically with Monte Carlo simulation and experimentally using optical phantoms, which confirms the system is capable of consistently acquiring total diffuse reflectance spectra and accurately converting them to the ratio of reduced scattering coefficient to absorption coefficient (µs’(λ)/µa(λ)). The spectral interpretation algorithm for µs’(λ)/µa(λ) was also validated based on Monte Carlo simulation. In addition, it has been demonstrated that the new measurement scheme and the spectral interpretation algorithm together are capable of detecting significant hemodynamic and scattering variations from the Wistar rats’ somatosensory cortex under forepaw stimulation. Finally, the feasibility of using dynamic intrinsic optical imaging to distinguish epileptogenic and normal cortex was validated in an in vivo study involving 11 pediatric patients with intractable epilepsy. Novel data analysis methods were devised and applied to the data from the study; identification of the epileptogenic cortex was achieved with a high accuracy

EpiGauss : caracterização espacio-temporal da actividade cerebral em epilepsia

Doutoramento em Engenharia ElectrotécnicaA epilepsia é uma patologia cerebral que afecta cerca de 0,5% da população mundial. Nas epilepsias focais, o principal objectivo clínico é a localização da zona epileptogénica (área responsável pelas crises), uma informação crucial para uma terapêutica adequada. Esta tese é centrada na caracterização da actividade cerebral electromagnética do cérebro epiléptico. As contribuições nesta área, entre a engenharia e neurologia clínica, são em duas direcções. Primeiro, mostramos que os conceitos associados às pontas podem ser imprecisos e não ter uma definição objectiva, tornando necessária uma reformulação de forma a definir uma referência fiável em estudos relacionados com a análise de pontas. Mostramos que as características das pontas em EEG são estatisticamente diferentes das pontas em MEG. Esta constatação leva a concluir que a falta de objectividade na definição de ponta na literatura pode induzir utilizações erradas de conceitos associados ao EEG na análise de MEG. Também verificamos que o uso de conjuntos de detecções de pontas efectuadas por especialistas (MESS) como referência pode fornecer resultados enganadores quando apenas baseado em critérios de consenso clínico, nomeadamente na avaliação da sensibilidade e especificidade de métodos computorizados de detecção de pontas Em segundo lugar, propomos o uso de métodos estatísticos para ultrapassar a falta de precisão e objectividade das definições relacionadas com pontas. Propomos um novo método de neuroimagem suportado na caracterização de geradores electromagnéticos – EpiGauss – baseado na análise individual dos geradores de eventos do EEG que explora as suas estruturas espacio-temporais através da análise de “clusters”. A aplicação de análise de “clusters” à análise geradores de eventos do EEG tem como objectivo usar um método não supervisionado, para encontrar estruturas espacio-temporais dps geradores relevantes. Este método, como processo não supervisionado, é orientado a utilizadores clínicos e apresenta os resultados sob forma de imagens médicas com interpretação similar a outras técnicas de imagiologia cerebral. Com o EpiGauss, o utilizador pode determinar a localização estatisticamente mais provável de geradores, a sua estabilidade espacial e possíveis propagações entre diferente áreas do cérebro. O método foi testado em dois estudos clínicos envolvendo doentes com epilepsia associada aos hamartomas hipotalâmicos e o outro com doentes com diagnóstico de epilepsia occipital. Em ambos os estudos, o EpiGauss foi capaz de identificar a zona epileptogénica clínica, de forma consistente com a história e avaliação clínica dos neurofisiologistas, fornecendo mais informação relativa à estabilidade dos geradores e possíveis percursos de propagação da actividade epileptogénica contribuindo para uma melhor caracterização clínica dos doentes. A conclusão principal desta tese é que o uso de técnicas não supervisionadas, como a análise de “clusters”, associadas as técnicas não-invasivas de EMSI, pode contribuir com um valor acrescido no processo de diagnóstico clínico ao fornecer uma caracterização objectiva e representação visual de padrões complexos espaciotemporais da actividade eléctrica epileptogénica.Epilepsy is a brain pathology that affects 0.5% of the world population. In focal epilepsies, the main clinical objective is the localization of the epileptogenic zone (brain area responsible for the epileptic seizures – EZ), a key information to decide an adequate therapeutic approach. This thesis is centred on electromagnetic activity characterization of the epileptic brain. Our contribution to this boundary area between engineering and clinical neurology is two-folded. First we show that spike related clinical concepts can be unprecise and some do not have objective definitions making necessary a reformulation in order to have a reliable reference in spike related studies. We show that EEG spike wave quantitative features are statistically different from their MEG counterparts. This finding leads to the conclusion that the lack of objective spike feature definitions in the literature can induce the wrong usage of EEG feature definition in MEG analysis. We also show that the use of multi-expert spike selections sets (MESS) as gold standard, although clinically useful, may be misleading whenever defined solely in terms of clinical agreement criteria, namely as references for automatic spike detection algorithms in sensitivity and specificity method analysis. Second, we propose the use of statistical methods to overcome some lack of precision and objectivity in spike related definitions. In this context, we propose a new ElectroMagnetic Source Imaging (EMSI) method – EpiGauss – based on cluster analysis that explores both spatial and temporal information contained in individual events sources analysis characterisation. This automatic cluster method for the analysis of spike related electric generators based in EEG is used to provide an unsupervised tool to find their relevant spatio-temporal structures. This method enables a simple unsupervised procedure aimed for clinical users and presents its results in an intuitive representation similar to other brain imaging techniques. With EpiGauss, the user is able to determine statistically probable source locations, their spatial stability and propagation patterns between different brain areas. The method was tested in two different clinical neurophysiology studies, one with a group of Hypothalamic Hamartomas and another with a group of Occipital Epilepsy patients. In both studies EpiGauss identified the clinical epileptogenic zone, consistent with the clinical background and evaluation of neurophysiologists, providing further information on stability of source locations and their probable propagation pathways that enlarges their clinical interpretation. This thesis main conclusion is that the use of unsupervised techniques, such as clustering, associated with EMSI non-invasive techniques, can bring an added value in clinical diagnosis process by providing objective and visual representation of complex epileptic brain spatio-temporal activity patterns

Automatic Detection and Classification of Neural Signals in Epilepsy

The success of an epilepsy treatment, such as resective surgery, relies heavily on the accurate identification and localization of the brain regions involved in epilepsy for which patients undergo continuous intracranial electroencephalogram (EEG) monitoring. The prolonged EEG recordings are screened for two main biomarkers of epilepsy: seizures and interictal spikes. Visual screening and quantitation of these two biomarkers in voluminous EEG recordings is highly subjective, labor-intensive, tiresome and expensive. This thesis focuses on developing new techniques to detect and classify these events in the EEG to aid the review of prolonged intracranial EEG recordings. It has been observed in the literature that reliable seizure detection can be made by quantifying the evolution of seizure EEG waveforms. This thesis presents three new computationally simple non-patient-specific (NPS) seizure detection systems that quantify the temporal evolution of seizure EEG. The first method is based on the frequency-weighted-energy, the second method on quantifying the EEG waveform sharpness, while the third method mimics EEG experts. The performance of these new methods is compared with that of three state-of-the-art NPS seizure detection systems. The results show that the proposed systems outperform these state-of-the-art systems. Epilepsy therapies are individualized for numerous reasons, and patient-specific (PS) seizure detection techniques are needed not only in the pre-surgical evaluation of prolonged EEG recordings, but also in the emerging neuro-responsive therapies. This thesis proposes a new model-based PS seizure detection system that requires only the knowledge of a template seizure pattern to derive the seizure model consisting of a set of basis functions necessary to utilize the statistically optimal null filters (SONF) for the detection of the subsequent seizures. The results of the performance evaluation show that the proposed system provides improved results compared to the clinically-used PS system. Quantitative analysis of the second biomarker, interictal spikes, may help in the understanding of epileptogenesis, and to identify new epileptic biomarkers and new therapies. However, such an analysis is still done manually in most of the epilepsy centers. This thesis presents an unsupervised spike sorting system that does not require a priori knowledge of the complete spike data